Changes in High-Sensitivity Troponin I Dynamics Pre and Post Parturition are Phenotype Specific
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Background
Hypertensive disorders of pregnancy (HDP), including preeclampsia (PEC) and chronic/gestational hypertension (HTN), are major causes of maternal morbidity and long-term cardiovascular risk. Although high-sensitivity cardiac troponin (hs-cTn) is a marker of myocardial injury, its peripartum dynamics across HDP phenotypes are not well characterized.
Methods
A retrospective cohort study was conducted. Pregnant patients ≥18 years with samples within ±48 hours of delivery were included. Mixed-effects linear regression compared log10-transformed hs-cTnI levels and slopes across PEC, HTN, and normotensive controls (NC), adjusting for clinical covariates.
Results
Among 609 participants, median hs-cTnI increased significantly after delivery across all groups. Adjusted models showed higher hs-cTnI in PEC vs NC (β=0.266, p<0.001) and HTN (β=0.160, p=0.011), and in HTN vs NC (β=0.107, p=0.046). Slopes were steeper in PEC vs NC (β=0.005/h, p=0.013), but not between PEC and HTN.
Conclusions
These findings support the concept of delivery as a physiologic “stress test” and provide new insights into phenotype-specific cardiovascular burden in pregnancy.
